MEDICARE: DR. SUSAN ELIZABETH LANGONE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD031364	TN
2	208000000X	Pediatrics Physician	K5328	TX

General Provider Information

NPI Number	:	1962407031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN ELIZABETH LANGONE M.D.

Provider Business Mailing Address
First Line	:	741 PRESIDENT PL
Second Line	:	STE 210
City	:	SMYRNA
State	:	TN
Zip	:	37167-6809
Country	:	US
Telephone Number	:	615-223-5565
Fax Number	:	615-223-5509

Provider Business Practice Location Address
First Line	:	741 PRESIDENT PL
Second Line	:	STE 210
City	:	SMYRNA
State	:	TN
Zip	:	37167-6809
Country	:	US
Telephone Number	:	615-223-5565
Fax Number	:	615-223-5509

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/14/2013

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Directions to “ DR. SUSAN ELIZABETH LANGONE M.D.” Practice Location

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